Primary trabeculectomy lowered IOP more than viscocanalostomy in POAG patients. However, the complication rate was lower in the viscocanalostomy group.
We aimed to investigate the long-term effect of microsurgical inguinal varicocelectomy on testicular blood flow using color Doppler sonography (CDS) in this observational study. A total of 30 patients clinically diagnosed with left varicocele who underwent a microsurgical inguinal varicocelectomy were examined 3 times with CDS for testicular blood flow parameters, first before, then 3 months after, and finally 6 months after the operation. CDS values of testicular blood flow (peak systolic velocity, end diastolic velocity, resistive index, and pulsatility index) were measured from testicular, capsular, and intratesticular arteries. We also evaluated preoperative and postoperative semen parameters. The mean values of blood flow velocities in the left testicular artery (peak systolic and end diastolic) increased and resistance indices (resistive and pulsatility) in the left capsular and intratesticular arteries decreased significantly after surgery (P , .05).No significant difference was detected between the preoperative and postoperative blood flow parameters in the right testicular, capsular, or intratesticular arteries (P , .05). In the semen analysis run 3 months after the operations, statistically significant increases were found in sperm concentration (P , .001), morphology percentage (P , .001), and total motile sperm concentration (P 5 .009). The increase in blood flow velocity in the testicular artery and the decrease in resistive and pulsatility indices in the capsular and intratesticular branches of the artery may be strong indicators of an increase in testicular arterial blood flow into the testicular tissue. Our data show that a significant improvement occurs in testicular blood supply and sperm parameters after microsurgical inguinal varicocelectomy.
Introduction: This article reviews the mechanisms affecting contraction and relaxation of the urethra in order to establish a basis for current and future treatments for urinary incontinence in women. Material and Methods: A review of the English literature using MEDLINE was performed between 1970 and 2008 on female urethra pharmacology, urinary incontinence, and mechanisms involved in contraction and relaxation of the female human urethra. Results: α-Adrenoceptors (ARs) cause contraction and β-ARs cause relaxation. Use of selective α-agonist and β-AR blocker agents might have potential for the treatment of stress urinary incontinence. Tolerable doses of cholinergic agonists did not have significant effects on intraurethral pressure. Nitric oxide seems to be the major nonadrenergic-noncholinergic inhibitory transmitter causing relaxation. c-kit-positive interstitial cells seem to regulate urethral tone. The roles of adenosine triphosphate and carbon monoxide have not been fully investigated in humans. Neuropeptides function similarly to the urinary bladder. Prostanoids cause urethral contraction and relaxation depending on their subtypes. Serotonin enhances the strength of urethral sphincteric contractions. The Rho-kinase pathway also appears to be modulating smooth muscle contraction in the urethra. Conclusions: Understanding of the urethral function and pharmacology may lead to the development of promising new agents which might be useful in the management of urinary incontinence in women.
We aimed to analyse the relationship between sperm parameters and International Index of Erectile Function (IIEF) score, the Female Sexual Function Index (FSFI) score, the testosterone (T) level in infertile men and between FSFI score and partners' fertility. Patients were divided into three groups; (group 1: azoospermia [n = 57], group 2: sperm count <15 million [n = 41], group 3: sperm count >15 million [n = 81]). Patients and their partners filled the IIEF and FSFI forms. The normality of the tests was analysed with Kolmogorov-Smirnov and Shapiro-Wilk tests. Spearman's rho test, a nonparametric test, was used to correlate the data. A value of p < .05 was considered statistically significant. There was a positive correlation between the sperm count, other sperm parameters, morphology and motility and IIEF score, FSFI score and T (p = .037, .028 and .041 respectively). We found a positive correlation between IIEF score and FSFI score (p = .182). Infertile partners' FSFI score was lower than fertile partners' scores (p = .023). Male infertility causes severe sexual dysfunction in couples, and female sexual dysfunction increases in parallel to that of men. Male sexual function also tends to decrease with low sperm count. While the clinician evaluates infertile couples, psychological and sexual functions should also be evaluated and patients should not be deprived of appropriate treatment.
Purpose: We aimed to evaluate the effects of smoking cessation on the sexual functions in men aged 30 to 60 years. Materials and Methods: Male patients aged 30 to 60 years that presented to the smoking cessation polyclinic between July 2017 and December 2018 were prospectively included in the study. The amount of exposure to tobacco was evaluated in packyear. The patients filled the International Index of Erectile Function (IIEF) form before the cessation and six months after cessation of smoking. Patients were subgrouped according to age, education level and packs/year of smoking and this groups were compared in terms of IIEF total and all of the IIEF domains. Results: The evaluations performed by grouping the patients according to age (30-39, 40-49 and 50-60 years) and education level (primary-middle school and high schooluniversity) revealed that the total IIEF scores obtained after smoking cessation were significantly higher compared to the baseline scores in all groups (p=0.007 for the 30-39 years group and p <0.001 for the remaining groups). According to grouping by exposure to smoking (≤25, 26-50, 51-75, 76-100 and 101≥ packs/year), the total IIEF scores significantly increased after smoking cessation in all groups except 101≥ packs/ year (p=0.051 for the 101≥ group and p <0.001 for the remaining groups). Conclusions: Erectile function is directly proportional to the degree of exposure to smoking, and quitting smoking improves male sexual function in all age groups between 30-60 years of age regardless of pack-year and education level.
We report a case of hemorrhagic detachment of Descemet's membrane after viscocanalostomy. A 60-year-old man with pseudoexfoliative glaucoma had an uneventful viscocanalostomy in the right eye. On the first postoperative day, a 5.0 mm x 5.0 mm Descemet's membrane detachment was present in the superior nasal quadrant. The space between Descemet's membrane and the stroma was filled with a hemorrhage. The hemorrhage resorbed by 6 months postoperatively, and Descemet's membrane completely reattached without surgical manipulation. The final visual acuity dropped from 20/40 to 20/100, final intraocular pressure was 20 mm Hg with 1 medication, and a paracentral fibrinoid scar persisted 18 months after surgery. Hemorrhagic detachment of Descemet's membrane can cause visual acuity deterioration and should be recognized as a rare complication of viscocanalostomy.
<b><i>Introduction:</i></b> We aimed to evaluate the predictive factors in a holistic manner for ureterorenoscopy (URS) outcomes in proximal ureteral stones by a multicenter study. <b><i>Materials and Methods:</i></b> The data of patients who underwent URS for proximal ureteral stones between the years 2015 and 2018 in eight centers were recorded retrospectively. Patients were divided into two groups according to URS success: Group 1 consisted of patients with successful URS, and Group 2 consisted of patients with unsuccessful URS. The two groups were compared in terms of risk factors, stone, and clinical characteristics of patients. <b><i>Results:</i></b> A total of 638 patients were included in the study. Group 1 consisted of 527 (82.6%) patients, and Group 2 consisted of 111 (17.4%) patients. In multivariate logistic analysis, the key risk factors for URS success was found to be age (OR = 0.980, 95% [CI] = 0.963–0.996, <i>p</i> = 0.018), stone area (OR = 0.993, 95% [CI] = 0.989–0.997, <i>p</i> = 0.002), and operation time (OR = 0.981, 95% [CI] = 0.968–0.994, <i>p</i> = 0.005). <b><i>Conclusions:</i></b> To make the treatment decision of proximal ureteral stones, it is necessary to examine several parameters including available equipment, stone, and patient characteristics. Physicians should keep these risk factors in mind in the decision of treatment options.
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